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<br />AfiACHMENT "E"
<br />Request for Taxpayer
<br />ldentification Number and Certificatlon
<br />Go to wwriRgoylFomWll for instructions and the lateet intomation.
<br />(Rsv. Mdrch 2024)
<br />Depad!n6nt 01 lhe Tr6ury
<br />lntomal Rdonua Soruica
<br />General lnstructions
<br />Sstion rsletences are to the lntenral Flevenue Code unless o:heruise
<br />noted.
<br />Futuro d€v€lopmant$. For the lalest infomation about developmenls
<br />related to Form !V-9 and its insinrclions, such as legislation enacted
<br />aiter tney were published, go lo ww.i6.gov/Fomv/9,
<br />What's New
<br />Line 3a has been modilied to clar{y how a disreguded entity cornpletss
<br />thrs line. An LLC that is a disregarded entity should chek the
<br />appropriate box for th€ :ax clsssification of its owner. Ctheeruise, it
<br />should check the "LLC' box and enie..ts approprate tax classificalion.
<br />Give form to tho
<br />requester. Do not
<br />send to the lRS.
<br />iApplias @ accNuts mitlaioad
<br />outsidB the Unlted Staies.l
<br />Be{ore you For guidanco relatod to ths of Forrr W-9, sm of Form, below.
<br />1 Nme of entity/individusl. An entry is required. {For a sle propr'stor or Cisregard€d enlity, ent€r the o\,/ner'3 fare on iine 1, and 6nter iho businep?igregarded
<br />*tl/'s rfre on 1ne 2 )
<br />2 Bu$ino$s namo/disregarcgd ontity ^amo.
<br />f difforont f.om abo./o-
<br />4 ExomptioDs icods apply onlyto
<br />mrtnin entiti€, not individuals:
<br />ss ir€lnrctDns on p.aoe 3i:
<br />Exemot pay* rode (it asy)
<br />Exed!otion fron Fo'€ign Account Tax
<br />Complianee Act IrATCA) r€portinq
<br />code {it sy)
<br />oa
<br />oIo
<br />OEoo>E
<br />OE
<br />=6
<br />Co
<br />o
<br />t
<br />ooa Requrster's nEme anrt fidcress ioollon6i)
<br />7 i sl accarnl rrmber(si here ioplionat
<br />ldentificstion Number
<br />Entar your TIN in the appropriate box. The TlN provided must match the rame grven on line 1 to avoid
<br />backup wilhholding. For,ndividuals, rhrs 1s ganerally your social securily numb€r {SSN}. Howsver. for a
<br />residmt alien. sol6 propdelor, or disregarded enllty, see tl.a inst.uctions ior Part I, iater. For olher
<br />enbties. !t is your employer identification rrunber (ElN) lf you do not have a 4urnber, see How lo gef a
<br />ft^r. later.
<br />SlqnqtuE of
<br />U.S, pcr3on Dato
<br />or
<br />Note: lf thc account rs in more than one name. sae the rnsfuctions for line 1 . See also lryhat Name and
<br />Number To Aiva the Re<luesler for guidelrnes on whoea number to enter.
<br />Gertilication
<br />Under penalties of perjury, I certify that:
<br />1 lhe number shown on thrs form rs my correci taxpayer identificalion number {or I am waiting lor a number to De isslred lo me); and
<br />2. I am qot subjecl lo backup wilhholoing bmause {a) I am exempt from bac<up witl,holding, or {b} I have nol been nolifred by lhe Intemal Revenile
<br />Serurce (lRS) thar I am subject io backup vJithholding as a rsult of a iailure tc repolt all inteiest or dividerds. o{ ic) lhe iBS nas rotiiied me that I arn
<br />no ronger sublst to baclep withholding; md
<br />3 I am a U.S. crtizen or other U S. oerson {d€finsd below): and
<br />.1. The FATCA code(s) entersd or ihis forr (if any) indicaling thal I am exempt from FATCA reporling ,s correct.
<br />Cdrtificalion instruclions. You nrusl cross 3ut ,lem 2 atlove if you have treen notified by the IRS lhat you ile currenlly subJect to backup withholdirg
<br />because you iava iaiied to recdrt all interest and dividends on your la retum. l-or real eslate tlansactions, ilem 2 coes pot apply. For mortgage ioieresl oaid
<br />acquisition or abandonr€nt ot ssureo propeny, cmcellation ol d€bt, contribulions lo an individua, retiremsrt arangemeni (lBA), and, genorally. payments
<br />olher than irtsrest and dividonds,ara rot io ths ceriiflcation. out Tust providg your corEct TIN S* thejnstructions for Part ll, laler.
<br />Sign
<br />Here
<br />New line 3b has b6en added to thrc fom. A flow-through anlity is
<br />required to complete this lil.e to indicate lhat jt has dirmt or indirect
<br />loreign partners, owners, or beneficiaies,.{fien ii provides the Fonn W-9
<br />to another flow'thrcugh entity in which .t has an cv/nership interest. Thrs
<br />change is intendad to provida a flow-tl'rough enlily wrth ]nformation
<br />regarding lhs status of ils indirmt loreign oartns6, ownars. or
<br />oeneticiaries, so that it can saiisfy any applicable reporting
<br />requirements. For exmple. a partnersnip that has arry inditect io.eign
<br />partners may be rsqurrad to complgte Schedulss K-2 and K-3. See th€
<br />Padnership lnstructions for Schedules K-2 and K-3 (Fom 1O65).
<br />Purpose of Form
<br />Ail indlvidual or entity (Form W-9 reqLlester) who ,s required lo lile art
<br />:nlorrnation relum with tne IRS is giving you this lorrn because they
<br />3r Ch€ck the appropriale box 'or fcderal lu ciassfication qf the slrly/lndrrdual whoae narn€ is efllered on ltnB L Check
<br />only onc of lho lollowing sav6n boxaa.
<br />n rndivjduavsolo propiictor f] C corpor*ion E S co.poqtion f] rartretrio fl Trust/cstato
<br />n LLC. €ntothutu cla$sificaljon (C=Ccorpo€tion, S = S corporation, P = Pa,-tile.sh;p)
<br />Note: Ch{k tt'€ "l,t"C" box ahve sd, in the entry spil9, ente. ihe approprlate code (C, S. or P) {or lh€ ld
<br />cla$slflcation ol lha LLC, unlqss it is a disregardod entlty. A dis/€gardod ontity should inslead cl..ek lh6 aoproprial6
<br />box ior th€ tu classificalion ol it3 owns
<br />n Oth{ {sA€ inAkuct'oils)
<br />3b rf on line 3a yau check€d 'Parlne6hlp" gr "lrusu6iato." tr cl'6ked "LLC" and g.tgred "P' as ts iu clnsEiiication.
<br />md you a.e providang this lom lo a pnrinerghrp, trusi, or Estale rn which you have an ovtnersnro rnletssl, check
<br />lhis bq if i,oo haye eny loreigf, parlnsH, owne6, or betleliclaries. See,nslr,rsliont
<br />5 Address (nL6be., gtr@t, and npt or $rrle no ). See inslruclions.
<br />6 Ci!y, state. sd ZIP code
<br />Part I
<br />Emplqyer ldantmcation rumber
<br />Part ll
<br />Cal. No. 10'131X
<br />Kittitas County Agreement for Services (rev.5/1,4/251
<br />Page 14 of 19
<br />Form W-9lFev l'202-li
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